Aids in the Management of Clustering, Frequency, Flatulence and Incontinence
Important note: If you have had surgery recently and are still in a period of healing, it is highly suggested that you wait to try any form of irrigation. Allow your body time to heal and recover before considering this option. You want your body to regain as much function as possible before introducing irrigation. Not waiting could affect long term outcomes. As with any other treatment, consult with your doctor before attempting irrigation.
Lower Colon irrigation is a common strategy for many living with LARS. There are a few options for this and knowing the differences and challenges associated with each system, can help you determine the best possible system for you. Rectal irrigation refers to the use of water, introduced into the lower colon via the anus, to assist with the evacuation of feces from the lower colon. This is commonly referred to as a “clean out”. By doing so, the lower colon remains empty for a period of time, offering relief from clustering and frequency.
Warm Water Enemas– Warm water enemas are the most common irrigation system used by those living with LARS. It it important to note that this system refers to the use of a medical grade enema kit, 4-6 cups of warm water, a proper nozzle and a lot of patience and practice. Most patients who have established this routine report that they can go 24- 48 hours between bowel movements. In some cases, people find that using frequent enemas allows them to eat foods that once posed problems.This seems to vary from person to person.
There is a lot of internet talk promoting the use of additives with the warm water, including salts, soaps, coffee, etc.. Warm water alone has shown to be effective and safe and using additives is not recommended without medical advice.. If you are considering using additives, please speak with your doctor beforehand.
Click here for more details and instructions about warm water enemas.
Peristeen System– This system is available through your medical provider and requires purchase of the delivery system and replacement supplies including a one-time use catheter nozzle. The catheter includes an inflatable rubber balloon that is filled with air once inserted into the colon, creating a seal and therefore preventing water leakage. With this system, a person can perform the enema while sitting on the toilet rather than lying on the floor. Some people living with LARS have found this system for lower bowel irrigation to be quite good, but the system is also costly. This may be a viable option if covered by your insurance provider. As an alternative, warm water enemas can provide a similar sitting experience by using an inflatable nozzle, also referred to as a “retention” nozzle. See Appendix B for further information.
Other Irrigations Sources– There are other irrigation devices and systems available, such as saline enemas (such as Fleet), suppositories and hand held bulb syringe devices. Some of those living with LARS have reported that these systems have been used and in some cases work, but in most cases they are not as effective as the warm water full enemas. Some have reported that they have tried these and they can be no help at all. Saline enemas contain saline (salt pulls water out of the bowel) and can only likely provide a clean out of the very lowest portion of the colon/rectum. The same is true for a bulb syringe enema and it may be a good backup system when warranted, but give only temporary, short-lived relief.
Again, if you are considering performing any enemas soon after cancer treatment, it is important to consult your doctor to determine if irrigation is safe for you.